EDA-23429-65345

2 vaccinations 9 coded responses 16 check-ins 9 free-text entries 2 call cases

Sex: Female
Age at first dose: 41-45
ZIP prefix: 999 / AK
Registered: 2021-09-15

Relationship: Self
Race: White
Ethnicity: Not Hispanic or Latino

Timeline

Registration Vaccinations Survey responses Call reports Cases without a report Call attempts Call successful Pregnancy survey

2021-09-15
Registered in v-safe
2021-09-15
Dose 1 — Moderna
2021-09-16
Survey response — days 1–6 daily, dose 1
MedDRA: Amnesia, Confusional state, Disturbance in attention, Dizziness, Dysarthria, Dyspnoea, Eructation, Vision blurred — Feeling: Poor · Site: Pain, Redness · Fever · Chills, Headache, Fatigue or tiredness, Nausea · Be unable to work or attend school, Be unable to do your normal daily activities

Free text: Hazy vision, dizziness, burping, confusion, slurred speech, cant muilt-task, hard time breathing, memory loss

MedDRA releases: 2024-11 · check-in free text available
2021-09-17
Survey response — days 1–6 daily, dose 1
MedDRA: Dizziness, Motion sickness — Feeling: Poor · Site: Pain · Fever · Chills, Headache, Muscle or body aches, Fatigue or tiredness, Nausea, Vomiting, Diarrhea, Abdominal pain · Be unable to do your normal daily activities

Free text: Dizziness, got car sick

MedDRA releases: 2024-11 · check-in free text available
2021-09-18
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Fever · Chills, Headache

Adult check-in
2021-09-19
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Headache, Nausea, Vomiting

Adult check-in
2021-09-20
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Headache

Adult check-in
2021-09-21
Health check-in — days 1–6 daily, dose 1
Feeling: Fair · Headache · Be unable to do your normal daily activities

Adult check-in
2021-09-22
Survey response — day 7, dose 1
MedDRA: Chest discomfort — Feeling: Poor · Headache, Fatigue or tiredness, Vomiting · Be unable to do your normal daily activities

Free text: Upper chest is tight

MedDRA releases: 2024-11 · check-in free text available
2021-10-06
Survey response — day 21, dose 1
MedDRA: Headache, Oropharyngeal pain — Feeling: Fair

Free text: Sore throat and head aches are worsening

MedDRA releases: 2024-11 · check-in free text available
2021-10-20
Dose 2 — Moderna
2021-10-22
Health check-in — days 1–6 daily, dose 2
Feeling: Poor · Site: Pain, Redness, Swelling · Fever · Chills, Joint pains, Muscle or body aches, Fatigue or tiredness, Nausea · Be unable to work or attend school

Adult check-in
2021-10-23
Survey response — days 1–6 daily, dose 2
MedDRA: Chest pain — Feeling: Good · Site: Pain, Swelling

Free text: Cheat pain

MedDRA releases: 2024-11 · check-in free text available
2021-10-24
Survey response — days 1–6 daily, dose 2
MedDRA: Chest pain, Dizziness — Feeling: Fair · Site: Pain, Swelling · Fatigue or tiredness

Free text: Dizzy and chest pain

MedDRA releases: 2024-11 · check-in free text available
2021-11-10
Health check-in — day 21, dose 2
Feeling: Fair

Adult check-in
2021-11-17
Survey response — day 28, dose 2
MedDRA: Bronchial disorder, Chest pain, Cough, Dizziness, Exposure to SARS-CoV-2, Migraine — Feeling: Poor · Be unable to work or attend school

Free text: Migraine, dizziness, chest hurts, occasionally coughing with some irregular asthma issues. I tested on Saturday 11/13 but my test came back negative not sure if I tested too early. My co-worker received positive for covid on 11/12

MedDRA releases: 2024-11 · check-in free text available
2021-11-24
Health check-in — day 35, dose 2
Feeling: Fair

Adult check-in
2021-12-03
Survey response — day 42, dose 2
MedDRA: Migraine, Respiratory disorder, Vision blurred — Feeling: Poor · Get care from a doctor or other healthcare professional · Outpatient clinic or urgent care clinic visit

Free text: Migraines, breathing issues, blurred vision

MedDRA releases: 2024-11 · check-in free text available
2021-12-03
Report sent to call center — day 42, dose 2
Get care from a doctor or other healthcare professional

Outpatient clinic or urgent care clinic visit · 1 call case(s)
2021-12-06
Call 1 — Left Voicemail
2022-01-19
Survey response — 3 months, dose 2
MedDRA: Dyspnoea, SARS-CoV-2 test positive — Feeling: Poor · Be unable to work or attend school, Be unable to do your normal daily activities, Get care from a doctor or other healthcare professional · Telehealth, virtual health, or email health consultation

Free text: I got a positive Covid test on 1/7/22. I've been short of breath and using my nebulizer every 4 hours

MedDRA releases: 2024-11 · check-in free text available
2022-01-19
Report sent to call center — 3 months, dose 2
Be unable to work or attend school · Be unable to do your normal daily activities · Get care from a doctor or other healthcare pr

Telehealth, virtual health, or email health consultation · 1 call case(s)
2022-01-20
Call successful
Completed over the phone

Vaccinations

Dose	Date	Manufacturer	Co-administered
1	2021-09-15	Moderna	No
2	2021-10-20	Moderna	No

Call center

2 call center cases

2 successful

VAERS report filed, before or during a call: 2

See the call center timeline

Free text

Release 9 — days 1–6 daily, dose 1

2021-09-16

Systemic reaction (other): Hazy vision, dizziness, burping, confusion, slurred speech, cant muilt-task, hard time breathing, memory loss

2021-09-17

Systemic reaction (other): Dizziness, got car sick

Release 9 — day 7, dose 1

2021-09-22

Systemic reaction (other): Upper chest is tight

Release 10 — day 21, dose 1

2021-10-06

Symptoms: Sore throat and head aches are worsening

Release 10 — days 1–6 daily, dose 2

2021-10-23

Systemic reaction (other): Cheat pain

2021-10-24

Systemic reaction (other): Dizzy and chest pain

Release 10 — day 28, dose 2

2021-11-17

Symptoms: Migraine, dizziness, chest hurts, occasionally coughing with some irregular asthma issues. I tested on Saturday 11/13 but my test came back negative not sure if I tested too early. My co-worker received positive for covid on 11/12

Release 10 — day 42, dose 2

2021-12-03

Symptoms: Migraines, breathing issues, blurred vision

Release 10 — 3 months, dose 2

2022-01-19

Symptoms: I got a positive Covid test on 1/7/22. I've been short of breath and using my nebulizer every 4 hours

Each entry is dated by the survey it was written in (the CDC re-sent the releases with survey dates in 2025); click a date to see that survey response. The CDC cut some text off at about 250 characters: symptoms in every release, and the other two fields in releases 9-12. Those entries are marked "cut off by CDC".

MedDRA terms by release

Field	Preferred term	2021-09	2023-04	2024-11
SD	Bronchial disorder	·	·	✓
SD	Chest pain	·	·	✓
SD	Cough	·	·	✓
SD	Dizziness	·	·	✓
SD	Dyspnoea	·	·	✓
SD	Exposure to SARS-CoV-2	·	·	✓
SD	Headache	·	·	✓
SD	Migraine	·	·	✓
SD	Oropharyngeal pain	·	·	✓
SD	Respiratory disorder	·	·	✓
SD	SARS-CoV-2 test positive	·	·	✓
SD	Vision blurred	·	·	✓
SRO	Amnesia	·	·	✓
SRO	Chest discomfort	·	·	✓
SRO	Chest pain	·	·	✓
SRO	Confusional state	·	·	✓
SRO	Disturbance in attention	·	·	✓
SRO	Dizziness	·	·	✓
SRO	Dysarthria	·	·	✓
SRO	Dyspnoea	·	·	✓
SRO	Eructation	·	·	✓
SRO	Motion sickness	·	·	✓
SRO	Vision blurred	·	·	✓

✓ active code · ○ coded but marked inactive · blank = not in that release